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Published in: Trials 1/2020

Open Access 01-12-2020 | Affective Disorder | Study protocol

Acupressure to improve sleep quality of older people in residential aged care: a randomised controlled trial protocol

Authors: Nant Thin Thin Hmwe, Graeme Browne, Lyndall Mollart, Viv Allanson, Sally Wai-Chi Chan

Published in: Trials | Issue 1/2020

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Abstract

Background

Sleep disturbance in older people is an important health issue that is associated with many other health problems. Effective interventions are required to address sleep problems in this group. Acupressure has been suggested as a potential therapeutic technique to improve sleep. The aim of this study is to evaluate the effects of an acupressure intervention on sleep quality, anxiety, depression, and quality of life among older persons in residential aged care facilities within an Australian context.

Methods/design

This is a randomised controlled trial with two parallel groups in a pre- and post-test study. Study participants will be older people living in residential aged care facilities. They will be assigned to intervention and control groups using computer-generated random numbers. The intervention group will receive 12-min acupressure three times per week for four consecutive weeks, applied on three acupoints: HT7, PC6, and SP6. The control group will receive only routine care. The primary outcome measure is sleep quality, and secondary outcomes include anxiety, depression, and quality of life. Data will be collected before the intervention, immediately after the end of the intervention, and 2 weeks after the intervention.

Discussion

This study targets a poorly met healthcare need of older people who are experiencing sleep disturbance and its negative consequences. To the researchers’ knowledge, this is the first study evaluating acupressure in an Australian aged care context, using specific acupoints and a standardised acupressure protocol. If the results show positive outcomes, acupressure could be used to manage sleep disturbances for older people in the Australian context as well as in the global ageing population. This will contribute to reducing negative consequences of sleep disturbance and use of sleep medications.

Trial registration

Australian New Zealand Clinical Trials Registry: ACTRN12619000262​101. Registered on 20 February 2019.
Appendix
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Literature
2.
go back to reference Zdanys KF, Steffens DC. Sleep disturbances in the elderly. Psychiatr Clin North Am. 2015;38:723–41.PubMedCrossRef Zdanys KF, Steffens DC. Sleep disturbances in the elderly. Psychiatr Clin North Am. 2015;38:723–41.PubMedCrossRef
3.
go back to reference Shi L, Chen SJ, Ma MY, Bao YP, Han Y, Wang YM, et al. Sleep disturbances increase the risk of dementia: a systematic review and meta-analysis. Sleep Med Rev. 2018;40:4–16.PubMedCrossRef Shi L, Chen SJ, Ma MY, Bao YP, Han Y, Wang YM, et al. Sleep disturbances increase the risk of dementia: a systematic review and meta-analysis. Sleep Med Rev. 2018;40:4–16.PubMedCrossRef
4.
go back to reference Hertenstein E, Feige B, Gmeiner T, Kienzler C, Spiegelhalder K, Johann A, et al. Insomnia as a predictor of mental disorders: a systematic review and meta-analysis. Sleep Med Rev. 2019;43:96–105.PubMedCrossRef Hertenstein E, Feige B, Gmeiner T, Kienzler C, Spiegelhalder K, Johann A, et al. Insomnia as a predictor of mental disorders: a systematic review and meta-analysis. Sleep Med Rev. 2019;43:96–105.PubMedCrossRef
5.
go back to reference Jarrin DC, Alvaro PK, Bouchard MA, Jarrin SD, Drake CL, Morin CM. Insomnia and hypertension: a systematic review. Sleep Med Rev. 2018;41:3–38.PubMedCrossRef Jarrin DC, Alvaro PK, Bouchard MA, Jarrin SD, Drake CL, Morin CM. Insomnia and hypertension: a systematic review. Sleep Med Rev. 2018;41:3–38.PubMedCrossRef
7.
go back to reference Alvaro PK, Roberts RM, Harris JK. A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep. 2013;36(7):1059–68.PubMedPubMedCentralCrossRef Alvaro PK, Roberts RM, Harris JK. A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep. 2013;36(7):1059–68.PubMedPubMedCentralCrossRef
8.
go back to reference Gindin J, Shochat T, Chetrit A, Epstein S, Ben Israel Y, Levi S, et al. Insomnia in long-term care facilities: a comparison of seven European countries and Israel: the services and health for elderly in long term care study. J Am Geriatr Soc. 2014;62(11):2033–9.PubMedCrossRef Gindin J, Shochat T, Chetrit A, Epstein S, Ben Israel Y, Levi S, et al. Insomnia in long-term care facilities: a comparison of seven European countries and Israel: the services and health for elderly in long term care study. J Am Geriatr Soc. 2014;62(11):2033–9.PubMedCrossRef
9.
go back to reference Li J, Yang B, Varrasse M, Li K. Sleep among long-term care residents in China: a narrative review of literature. Clin Nurs Res. 2018;27(1):35–60.PubMedCrossRef Li J, Yang B, Varrasse M, Li K. Sleep among long-term care residents in China: a narrative review of literature. Clin Nurs Res. 2018;27(1):35–60.PubMedCrossRef
10.
go back to reference Valenza MC, Cabrera-Martos I, Martín-Martín L, Pérez-Garzón VM, Velarde C, Valenza-Demet G. Nursing homes: impact of sleep disturbances on functionality. Arch Gerontol Geriatr. 2013;56(3):432–6.PubMedCrossRef Valenza MC, Cabrera-Martos I, Martín-Martín L, Pérez-Garzón VM, Velarde C, Valenza-Demet G. Nursing homes: impact of sleep disturbances on functionality. Arch Gerontol Geriatr. 2013;56(3):432–6.PubMedCrossRef
12.
go back to reference Chen L, Bell JS, Visvanathan R, Hilmer SN, Emery T, Robson L, et al. The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study. BMC Geriatr. 2016;16(1):196.PubMedPubMedCentralCrossRef Chen L, Bell JS, Visvanathan R, Hilmer SN, Emery T, Robson L, et al. The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study. BMC Geriatr. 2016;16(1):196.PubMedPubMedCentralCrossRef
13.
14.
go back to reference Cormier R. Sleep disturbances. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. 3rd ed. Boston: Butterworths; 1990. Cormier R. Sleep disturbances. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. 3rd ed. Boston: Butterworths; 1990.
15.
go back to reference Ma Y, Dong M, Mita C, Sun S, Peng CK, Yang AC. Publication analysis on insomnia: how much has been done in the past two decades? Sleep Med. 2015;16(7):820–6.PubMedCrossRef Ma Y, Dong M, Mita C, Sun S, Peng CK, Yang AC. Publication analysis on insomnia: how much has been done in the past two decades? Sleep Med. 2015;16(7):820–6.PubMedCrossRef
17.
go back to reference Capezuti E, Sagha Zadeh R, Pain K, Basara A, Jiang NZ, Krieger AC. A systematic review of non-pharmacological interventions to improve nighttime sleep among residents of long-term care settings. BMC Geriatr. 2018;18:143.PubMedPubMedCentralCrossRef Capezuti E, Sagha Zadeh R, Pain K, Basara A, Jiang NZ, Krieger AC. A systematic review of non-pharmacological interventions to improve nighttime sleep among residents of long-term care settings. BMC Geriatr. 2018;18:143.PubMedPubMedCentralCrossRef
18.
go back to reference Shang B, Yin H, Jia Y, Zhao J, Meng X, Chen L, et al. Nonpharmacological interventions to improve sleep in nursing home residents: a systematic review. Geriatr Nurs. 2019;40(4):405–16.PubMedCrossRef Shang B, Yin H, Jia Y, Zhao J, Meng X, Chen L, et al. Nonpharmacological interventions to improve sleep in nursing home residents: a systematic review. Geriatr Nurs. 2019;40(4):405–16.PubMedCrossRef
19.
go back to reference Hmwe NTT, Browne G, Mollart L, Allanson V, Chan SW. An integrative review of acupressure interventions for older people: a focus on sleep quality, depression, anxiety, and agitation. Int J Geriatr Psychiatry. 2019;34(3):381–96.PubMed Hmwe NTT, Browne G, Mollart L, Allanson V, Chan SW. An integrative review of acupressure interventions for older people: a focus on sleep quality, depression, anxiety, and agitation. Int J Geriatr Psychiatry. 2019;34(3):381–96.PubMed
20.
go back to reference Waits A, Tang YR, Cheng HM, Tai CJ, Chien LY. Acupressure effect on sleep quality: a systematic review and meta-analysis. Sleep Med Rev. 2018;37:24–34.PubMedCrossRef Waits A, Tang YR, Cheng HM, Tai CJ, Chien LY. Acupressure effect on sleep quality: a systematic review and meta-analysis. Sleep Med Rev. 2018;37:24–34.PubMedCrossRef
22.
go back to reference Chen IH, Yeh TP, Yeh YC, Chi MJ, Chen MW, Chou KR, et al. Effects of acupressure on sleep quality and psychological distress in nursing home residents: a randomized controlled trial. J Am Med Dir Assoc. 2019;20(7):822–9.PubMedCrossRef Chen IH, Yeh TP, Yeh YC, Chi MJ, Chen MW, Chou KR, et al. Effects of acupressure on sleep quality and psychological distress in nursing home residents: a randomized controlled trial. J Am Med Dir Assoc. 2019;20(7):822–9.PubMedCrossRef
23.
go back to reference Lai FC, Chen IH, Chen PJ, Chen IJ, Chien HW, Yuan CF. Acupressure, sleep, and quality of life in institutionalized older adults: a randomized controlled trial. J Am Geriatr Soc. 2017;65(5):e103–8.PubMedCrossRef Lai FC, Chen IH, Chen PJ, Chen IJ, Chien HW, Yuan CF. Acupressure, sleep, and quality of life in institutionalized older adults: a randomized controlled trial. J Am Geriatr Soc. 2017;65(5):e103–8.PubMedCrossRef
24.
go back to reference Zeng H, Liu M, Wang P, Kang J, Lu F, Pan L. The effects of acupressure training on sleep quality and cognitive function of older adults: a 1-year randomized controlled trial. Res Nurs Health. 2016;39(5):328–36.PubMedCrossRef Zeng H, Liu M, Wang P, Kang J, Lu F, Pan L. The effects of acupressure training on sleep quality and cognitive function of older adults: a 1-year randomized controlled trial. Res Nurs Health. 2016;39(5):328–36.PubMedCrossRef
25.
go back to reference Simoncini M, Gatti A, Quirico PE, Balla S, Capellero B, Obialero R, et al. Acupressure in insomnia and other sleep disorders in elderly institutionalized patients suffering from Alzheimer's disease. Aging Clin Exp Res. 2015;27(1):37–42.PubMedCrossRef Simoncini M, Gatti A, Quirico PE, Balla S, Capellero B, Obialero R, et al. Acupressure in insomnia and other sleep disorders in elderly institutionalized patients suffering from Alzheimer's disease. Aging Clin Exp Res. 2015;27(1):37–42.PubMedCrossRef
26.
go back to reference Au DWH, Tsang HWH, Ling PPM, Leung CHT, Ip PK, Cheung WM. Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupunct Med. 2015;33(5):353–9.PubMedCrossRef Au DWH, Tsang HWH, Ling PPM, Leung CHT, Ip PK, Cheung WM. Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupunct Med. 2015;33(5):353–9.PubMedCrossRef
27.
go back to reference Weiss-Farnan P. Acupressure. In: Snyder M, Lindquist R, editors. Complementary and alternative therapies in nursing. 6th ed. New York: Springer; 2010. Weiss-Farnan P. Acupressure. In: Snyder M, Lindquist R, editors. Complementary and alternative therapies in nursing. 6th ed. New York: Springer; 2010.
28.
go back to reference Kolster BC, Waskowiak A. The acupressure atlas. Rochester: Healing Arts Press; 2007. Kolster BC, Waskowiak A. The acupressure atlas. Rochester: Healing Arts Press; 2007.
29.
go back to reference Hsieh CL. Modern scientific explanation of traditional acupuncture theory. In: Hai H, editor. Acupuncture: theory and evidence. Singapore: World Scientific Publishing; 2013. p. 53–62.CrossRef Hsieh CL. Modern scientific explanation of traditional acupuncture theory. In: Hai H, editor. Acupuncture: theory and evidence. Singapore: World Scientific Publishing; 2013. p. 53–62.CrossRef
30.
go back to reference Huang W, Kutner N, Bliwise DL. A systematic review of the effects of acupuncture in treating insomnia. Sleep Med Rev. 2009;13(1):73–104.PubMedCrossRef Huang W, Kutner N, Bliwise DL. A systematic review of the effects of acupuncture in treating insomnia. Sleep Med Rev. 2009;13(1):73–104.PubMedCrossRef
31.
go back to reference Maciocia G. The foundations of Chinese medicine. London: Churchill Livingstone; 2005. Maciocia G. The foundations of Chinese medicine. London: Churchill Livingstone; 2005.
32.
go back to reference Hmwe NTT, Subramaniam P, Tan LP. Effectiveness of acupressure in promoting sleep quality: a systematic review of randomized controlled trials. Holist Nurs Pract. 2016;30(5):283–93.PubMedCrossRef Hmwe NTT, Subramaniam P, Tan LP. Effectiveness of acupressure in promoting sleep quality: a systematic review of randomized controlled trials. Holist Nurs Pract. 2016;30(5):283–93.PubMedCrossRef
33.
go back to reference Yeung WF, Chung KF, Leung YK, Zhang SP, Law ACK. Traditional needle acupuncture treatment for insomnia: a systematic review of randomized controlled trials. Sleep Med. 2009;10(7):694–704.PubMedCrossRef Yeung WF, Chung KF, Leung YK, Zhang SP, Law ACK. Traditional needle acupuncture treatment for insomnia: a systematic review of randomized controlled trials. Sleep Med. 2009;10(7):694–704.PubMedCrossRef
34.
go back to reference World Health Organization (WHO) Regional Office for the Western Pacific. WHO standard acupuncture point locations in the Western Pacific region. Manila: WHO; 2008. World Health Organization (WHO) Regional Office for the Western Pacific. WHO standard acupuncture point locations in the Western Pacific region. Manila: WHO; 2008.
35.
go back to reference Zhang R. Introduction to acupuncture and moxibustion. Singapore: World Scientific Publishing; 2014. Zhang R. Introduction to acupuncture and moxibustion. Singapore: World Scientific Publishing; 2014.
36.
37.
go back to reference Molloy DW, Alemayehu E, Roberts R. Reliability of a standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination. Am J Psychiatry. 1991;148(1):102–5.PubMedCrossRef Molloy DW, Alemayehu E, Roberts R. Reliability of a standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination. Am J Psychiatry. 1991;148(1):102–5.PubMedCrossRef
38.
go back to reference Lu MJ, Lin ST, Chen KM, Tsang HY, Su SF. Acupressure improves sleep quality of psychogeriatric inpatients. Nurs Res. 2013;62(2):130–7.PubMedCrossRef Lu MJ, Lin ST, Chen KM, Tsang HY, Su SF. Acupressure improves sleep quality of psychogeriatric inpatients. Nurs Res. 2013;62(2):130–7.PubMedCrossRef
39.
go back to reference Reza H, Kian N, Pouresmail Z, Masood K, Sadat Seyed Bagher M, Cheraghi MA. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Complement Ther Clin Pract. 2010;16(2):81–5.PubMedCrossRef Reza H, Kian N, Pouresmail Z, Masood K, Sadat Seyed Bagher M, Cheraghi MA. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Complement Ther Clin Pract. 2010;16(2):81–5.PubMedCrossRef
40.
go back to reference Freedland KE, Mohr DC, Davidson KW, Schwartz JE. Usual and unusual care: existing practice control groups in randomized controlled trials of behavioral interventions. Psychosom Med. 2011;73(4):323–35.PubMedPubMedCentralCrossRef Freedland KE, Mohr DC, Davidson KW, Schwartz JE. Usual and unusual care: existing practice control groups in randomized controlled trials of behavioral interventions. Psychosom Med. 2011;73(4):323–35.PubMedPubMedCentralCrossRef
41.
go back to reference Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRefPubMed Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRefPubMed
42.
go back to reference Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–70.PubMedCrossRef Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–70.PubMedCrossRef
43.
go back to reference Bowling A, Hankins M, Windle G, Bilotta C, Grant R. A short measure of quality of life in older age: the performance of the brief Older People's Quality of Life Questionnaire (OPQOL-Brief). Arch Gerontol Geriatr. 2013;56(1):181–7.PubMedCrossRef Bowling A, Hankins M, Windle G, Bilotta C, Grant R. A short measure of quality of life in older age: the performance of the brief Older People's Quality of Life Questionnaire (OPQOL-Brief). Arch Gerontol Geriatr. 2013;56(1):181–7.PubMedCrossRef
44.
go back to reference Spira AP, Beaudreau SA, Stone KL, Kezirian EJ, Lui L-Y, Redline S, et al. Reliability and validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older men. J Gerontol A Bio Sci Med Sci. 2011;67(4):433–9.CrossRef Spira AP, Beaudreau SA, Stone KL, Kezirian EJ, Lui L-Y, Redline S, et al. Reliability and validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older men. J Gerontol A Bio Sci Med Sci. 2011;67(4):433–9.CrossRef
45.
go back to reference Beaudreau SA, Spira AP, Stewart A, Kezirian EJ, Lui LY, Ensrud K, et al. Validation of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older black and white women. Sleep Med. 2012;13(1):36–42.PubMedCrossRef Beaudreau SA, Spira AP, Stewart A, Kezirian EJ, Lui LY, Ensrud K, et al. Validation of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older black and white women. Sleep Med. 2012;13(1):36–42.PubMedCrossRef
46.
go back to reference Rowe M, McCrae C, Campbell J, Horne C, Tiegs T, Lehman B, et al. Actigraphy in older adults: comparison of means and variability of three different aggregates of measurement. Behav Sleep Med. 2008;6(2):127–45.PubMedCrossRef Rowe M, McCrae C, Campbell J, Horne C, Tiegs T, Lehman B, et al. Actigraphy in older adults: comparison of means and variability of three different aggregates of measurement. Behav Sleep Med. 2008;6(2):127–45.PubMedCrossRef
47.
go back to reference Sadeh A. The role and validity of actigraphy in sleep medicine: an update. Sleep Med Rev. 2011;15(4):259–67.PubMedCrossRef Sadeh A. The role and validity of actigraphy in sleep medicine: an update. Sleep Med Rev. 2011;15(4):259–67.PubMedCrossRef
48.
go back to reference Roberts MH, Fletcher RB, Merrick PL. The validity and clinical utility of the Hospital Anxiety and Depression Scale (HADS) with older adult New Zealanders. Int Psychogeriatr. 2014;26(2):325–33.PubMedCrossRef Roberts MH, Fletcher RB, Merrick PL. The validity and clinical utility of the Hospital Anxiety and Depression Scale (HADS) with older adult New Zealanders. Int Psychogeriatr. 2014;26(2):325–33.PubMedCrossRef
50.
go back to reference National Health Medical Research Council. National statement on ethical conduct in human research. Canberra: Author; 2007. [updated 2018]. National Health Medical Research Council. National statement on ethical conduct in human research. Canberra: Author; 2007. [updated 2018].
Metadata
Title
Acupressure to improve sleep quality of older people in residential aged care: a randomised controlled trial protocol
Authors
Nant Thin Thin Hmwe
Graeme Browne
Lyndall Mollart
Viv Allanson
Sally Wai-Chi Chan
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Trials / Issue 1/2020
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-020-04286-2

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